What are the pharmacological classes of Saxenda (liraglutide) and Jardiance (empagliflozin)?

Pharmacological Classes of Saxenda (liraglutide) and Jardiance (empagliflozin)

Saxenda (liraglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist, while Jardiance (empagliflozin) is a sodium-glucose cotransporter-2 (SGLT-2) inhibitor. These medications belong to different pharmacological classes with distinct mechanisms of action for treating type 2 diabetes and obesity.

Saxenda (liraglutide)

• Liraglutide is a GLP-1 receptor agonist with 97% homology to human GLP-1, a gut-derived incretin hormone 1
• It was initially approved in 2010 for type 2 diabetes treatment at doses up to 1.8 mg daily, and later approved in 2014 as Saxenda at 3.0 mg dose for chronic weight management in patients with obesity 1
• Mechanism of action:
  • Stimulates insulin secretion and reduces glucagon secretion in a glucose-dependent manner 1
  • Improves satiety and promotes weight loss 1
  • Delays gastric emptying, which reduces energy intake 1
• Administration: Subcutaneous injection once daily, initiated at 0.6 mg daily and increased by 0.6 mg weekly until reaching 3.0 mg 1
• Clinical benefits beyond glucose control:
  • Demonstrated cardiovascular benefits in the LEADER trial, showing reduced composite outcomes for myocardial infarction, stroke, and cardiovascular death 1
  • Promotes weight loss in a dose-dependent manner 1

Jardiance (empagliflozin)

• Empagliflozin is a sodium-glucose cotransporter-2 (SGLT-2) inhibitor 1
• Mechanism of action:
  • Blocks glucose reabsorption in the proximal renal tubule, leading to increased urinary glucose excretion 1
  • Reduces hyperglycemia independent of insulin action 1
  • Promotes weight loss through caloric loss via glucosuria 1
• Administration: Oral medication 1
• Clinical benefits beyond glucose control:
  • Demonstrated cardiovascular benefits in the EMPA-REG OUTCOME trial, showing reduced composite outcomes for myocardial infarction, stroke, and cardiovascular death 1, 2
  • Associated with reduced risk of heart failure hospitalizations 1, 2
  • Shows renal protective effects 1, 3

Key Differences and Clinical Implications

• Different routes of administration:
  • Saxenda (liraglutide) is administered as a subcutaneous injection 1
  • Jardiance (empagliflozin) is taken orally 1
• Mechanism differences:
  • GLP-1 receptor agonists like liraglutide work primarily through incretin effects, enhancing insulin secretion and suppressing glucagon in a glucose-dependent manner 1
  • SGLT-2 inhibitors like empagliflozin work through an insulin-independent mechanism by increasing urinary glucose excretion 1
• Safety considerations:
  • Liraglutide's common side effects include nausea, vomiting, and gastrointestinal disturbances 1
  • Empagliflozin's side effects include genitourinary infections, potential risk of euglycemic diabetic ketoacidosis, and volume depletion 1

Potential Complementary Effects

• Both medications promote weight loss through different mechanisms 4
• Research suggests potential synergistic effects when used in combination, particularly for cardiovascular and renal protection 3, 5
• Both medications have demonstrated cardiovascular benefits in their respective outcome trials (EMPA-REG OUTCOME for empagliflozin and LEADER for liraglutide) 1, 2

Understanding the distinct pharmacological classes and mechanisms of these medications helps guide appropriate selection based on patient characteristics, comorbidities, and treatment goals.